运用白质地图定量分析多发性硬化小脑解剖连接改变的研究  

Atlas-based analysis of cerebellar anatomical connectivity in patients with relapsing-remitting multiple sclerosis

作　　者：耿海洋[1] 李松柏[1] 关丽明[1] 王永峰[1] 李造峰[1] 吴哲[2] 

机构地区：[1]中国医科大学附属第一医院放射科,辽宁沈阳110001 [2]中国医科大学附属第一医院神经内科,辽宁沈阳110001

出　　处：《实用放射学杂志》2016年第1期10-13,共4页Journal of Practical Radiology

基　　金：辽宁省科学技术计划基金资助项目（2012225021）.

摘　　要：目的 运用基于白质地图（ABA）的扩散张量成像（DTI）分析方法，探讨复发-缓解型多发性硬化（RRMS）患者表现正常小脑解剖连接隐匿损伤及DTI在多发性硬化临床研究中的价值。方法 选择RRMS患者21例及性别、年龄相匹配健康对照19例行常规磁共振及DTI扫描，DTI数据后处理获得小脑解剖连接（小脑中脚、小脑上脚和小脑下脚）的DTI参数值，其参数包括部分各向异性分数（FA）、平均扩散系数（MD）、径向扩散系数（RD）、轴向扩散系数（AD），进行2组数据比较分析，并将DTI参数值与临床残疾扩展评分、病程行相关性分析。结果 与对照组比较，RRMS组小脑中脚、左侧小脑上脚及双侧小脑下脚FA值降低、RD值升高（P〈0.05）；小脑中脚及左侧小脑下脚MD值、AD值升高（P〈0.05）。小脑中脚FA值与病程呈负相关，小脑中脚及右侧小脑下脚MD值、AD值、RD值分别与病程呈正相关。结论 RRMS患者表现正常小脑解剖连接存在隐匿性损伤，且DTI可在一定程度上监测患者病情。Objective To investigate the changes of normal appearances of cerebellar anatomical connectivity in patients with re lapsing-remitting multiple sclerosis （RRMS） using atlas-based analysis of diffusion tensor imaging （DTI） and to explore the clinical utility of DTI. Methods 21 patients with RRMS and 19 healthy controls were recruited. Conventional MRI and DTI were per-formed. Quantitative indexes as fractional anisotropy （FA）, mean diffusivity （MD）, radial diffusivity （RD） and axial diffusivity （AD） values in cerebellar connections, including middle cerebellar peduncle （MCP） , superior cerebellar peduncles （SCP} and inferi or cerebellar peduncles （ICP） were analyzed. Clinical scores in all patients were assessed including EDSS score and disease duration. Linear regression models were used to investigate their association between DTI indexes and clinical scores. Results In comparison with controls, reduced FA and increased RD in MCP, left SCP and bilateral ICP, as well as increased MD, AD in MCP and left ICP were found in patients （P〈0.05）. In RRMS, lower FA was associated with longer disease duration in MCP. And higher MD, AD and RD were associated with longer duration of illness in MCP and right ICP respectively. Conclusion The normal-appearing cere bellar anatomical connectivity have microstructural changes in RRMS patients. And to a certain extent, DTI indexes can monitor disease progression.

关 键 词：多发性硬化 复发-缓解型 扩散张量成像 小脑 解剖连接 

分 类 号：R742.82[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]